Serum Lipids and Glucose Abnormalities in HIV/AIDS Patients on Antiretroviral Therapies

Abstract

BACKGROUND: With the introduction of highly active antiretroviral therapy (HAART) the outlook of HIV/AIDS has changed from a killer disease to a treatable chronic infectious one. However HAART is associated with some metabolic disorders some of which are now being seen in people living with HIV/ AIDS (PLWHA) accessing care from our centre.
OBJECTIVE: To determine the prevalence and pattern of dyslipidaemia and dysglycaemia amongst Nigerian HIV/AIDS patients on HAART.
METHODS: PLWHA who were regular on ART for at least three months and had pre-treatment CD4+ count, fasting lipid and glucose profiles were grouped into two treatment regimens: protease inhibitor, (PI) or non-nucleoside reverse transcriptase inhibitor (NNRTI). Pre and post-exposure metabolic and nonmetabolic variables were compared for each regimen as well as within regimen comparison of the differences between post exposure metabolic variables.
RESULTS: Three hundred and twenty-seven patients; [male=134 (41%), female=193 (59%)] met the study criteria in the two groups: PI = 94(29%) and NNRTI= 233(71%). The pretreatment metabolic changes in both groups (PI vs. NNRTI) were low HDLC; 29(31%) vs.77 (33%), followed by hypertriglyceridaemia; 16(17%) vs.38 (16%) and hypercholesterolaemia; 6(6%) vs.10 (4%). After exposure to two different HAART regimens
hypertriglyceridaemia and hypercholesterolaemia became more prevalent especially with Pi based therapy than NNRTI; 74(79%) vs. 108(54%) and 58(51%) vs.72(31%) respectively. These relative higher risks of a PI containing regimen to induce hypertriglyceridaemia and hypercholesterolaemia were about three times more than that of NNRTI, both risks were statistically significant; p = 0.0003 and p = 0.0001.
CONCLUSION: Low HDL-C, hypertriglyceridaemia and hypercholesterolaemia are common in untreated HIV/AIDS patients. HAART especially those including protease inhibitors worsens this dyslipidaemia.

WAJM 2009; 28(1): 300–305.